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Diminishing benefits of urban living for children and adolescents' growth and development

Diminishing benefits of urban living for children and adolescents' growth and development
Diminishing benefits of urban living for children and adolescents' growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

0028-0836
874-883
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Fall, Caroline
7171a105-34f5-4131-89d7-1aa639893b18
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Westbury, Leo
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
NCD Risk Factor Collaboration (NCD-RisC)
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Fall, Caroline
7171a105-34f5-4131-89d7-1aa639893b18
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Westbury, Leo
5ed45df3-3df7-4bf9-bbad-07b63cd4b281

Cooper, Cyrus, Dennison, Elaine, Fall, Caroline, Osmond, Clive and Westbury, Leo , NCD Risk Factor Collaboration (NCD-RisC) (2023) Diminishing benefits of urban living for children and adolescents' growth and development. Nature, 615 (7954), 874-883. (doi:10.1038/s41586-023-05772-8).

Record type: Article

Abstract

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

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More information

Accepted/In Press date: 30 January 2023
Published date: 30 March 2023
Additional Information: Funding Information: This study was funded by the UK Medical Research Council (grant number MR/V034057/1), the Wellcome Trust (Pathways to Equitable Healthy Cities grant 209376/Z/17/Z), the AstraZeneca Young Health Programme and the European Commission (STOP project through EU Horizon 2020 research and innovation programme under Grant Agreement 774548). For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to the Author Accepted Manuscript version arising from this submission. We thank W. Dietz, L. Jaacks and W. Johnson for recommendations of relevant citations. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. Publisher Copyright: © 2023, The Author(s).

Identifiers

Local EPrints ID: 476302
URI: http://eprints.soton.ac.uk/id/eprint/476302
ISSN: 0028-0836
PURE UUID: 45c5bc49-78b9-4940-9449-79351e18a240
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Caroline Fall: ORCID iD orcid.org/0000-0003-4402-5552
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655
ORCID for Leo Westbury: ORCID iD orcid.org/0009-0008-5853-8096

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Date deposited: 19 Apr 2023 16:33
Last modified: 10 May 2023 01:45

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Contributors

Author: Cyrus Cooper ORCID iD
Author: Elaine Dennison ORCID iD
Author: Caroline Fall ORCID iD
Author: Clive Osmond ORCID iD
Author: Leo Westbury ORCID iD
Corporate Author: NCD Risk Factor Collaboration (NCD-RisC)

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